Fulminant course of hypertension caused by phaeochromocytoma

Journal of Clinical and Basic Cardiology 2000; 3 (1): 67-68

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Keywords: Hypertonie,  Myokardinfarkt,  Phäochromozytom,  hypertension,  myocardial infarction,  phaeochromocytoma

A 58 year old man, with a well known history of coronary heart disease and arterial hypertension, was admitted to hospital complaining of severe central chest pain. At time of admission BP was significantly raised and the patient presented with clinical shock-symptoms. ECG and laboratory controls showed no signs of acute myocardial ischaemia. Despite intravenous treatment with nitroglycerine, urapidil and beta-blockers blood pressure remained persistently high. Deterioration of the patients general condition eventually required intubation and controlled ventilation. Electromechanical dissociation appeared shortly thereafter and could not be overcome by prolonged resuscitation. Post mortem examination revealed a large phaeocromocytoma and myocardial infarction of the posterior wall as the immediate cause of death. It is of interest that in this case the primary onset of a formerly undiagnosed phaeocromocytoma lead to prolonged hypertension almost insusceptible to standard treatment and eventually to fatal myocardial infarction within hours of onset of symptoms. J Clin Basic Cardiol 2000: 3: 67-8.